The women’s health care program in Texas still has a long way to go.
According to the Texas Health and Human Services Commission, Healthy Texas Women, the state’s family-planning program and the breast exam and cervical cancer screening program served about 250,000 women last year. In 2010, the year before Planned Parenthood was removed from the programs, the state served more than 350,000 women.
Dr. Brook Randal prescribes birth control pills to women through an app called Nurx, which has been operating in Texas for about a year.
“I certainly process a lot of Nurx prescriptions for women who are on the [Healthy Texas Women] program,” she says.
The Healthy Texas Women program is the latest incarnation of a state-run program that provides contraception and health care to low-income women.
Nurx makes getting birth control cheaper and more convenient. Women don’t have to go to a doctor’s office to get a prescription and then to a pharmacy to pick it up. Everything is done through the app, and pills are sent through the mail. This is especially helpful for women who don’t have nearby clinics or doctors to go to in the first place, including women who are supposed to be getting care from Healthy Texas Women.
“I think we've proven that it is easier to dismantle and tear down a system than it is to build it back,” says Stacey Pogue, a policy analyst with the Center for Public Policy Priorities in Austin. “Even when you have the intention to build it back.”
Pogue says the state has tried to replace Planned Parenthood, which was once the most used provider in the program. In fact, there are more providers in Healthy Texas Women now. But they’re serving fewer people, Pogue says.
“I suspect the ones in the rural areas were the least likely to have other providers there in the county or in the community to try to step up and serve those women,” she says.
According to the Texas Health and Human Services Commission, about 244,869 women were enrolled in Texas Healthy Women as of December 2017. However, roughly half of those women – 122,327 – received services through the program.
Randal says she’s helping out women who need contraception but haven't found a way to get it through the current provider system.
“Many women live in communities where there is no provider that accepts [Healthy Texas Women], because the reimbursement is poor,” she says.
So far, a small percentage of the women using Nurx are in Healthy Texas Women. According to Nurx, it’s a little more than 3 percent of users.
And women seeking more effective forms of birth control, such as IUDs and implants, still have to find a provider through the program.